拉米夫定联合泛昔洛韦治疗慢性乙型肝炎

Treatment of chronic hepatitis B by Lamivudine combined with famciclovir

目的 研究LMD和FCV联合疗法对慢性乙型肝炎感染的疗效。方法 联合治疗组用拉米夫定100 mg·d-1口服,疗程12个月,拉米夫定治疗开始时给予泛昔洛韦500 mg,tid口服12个月。拉米夫定组仅给予拉米夫定100 mg·d-1口服,疗程12个月。于治疗开始后第1,3,6,9,12及治疗结束后第3,6,12个月进行临床评估及实验室检查。结果 治疗后6个月、12个月、随访6个月、12个月时ALT复常率各时间段联合治疗组均高于拉米夫定组。差异有显著和非常显著意义。治疗后6个月、12个月和随访6个月、12个月时血清HBV DNA转阴率:联合治疗组各时段均高于拉米夫定组,但2组比较差异无显著意义。结论 LMD和FCV有协同或相加性抗HBV作用,且停药后DHBV DNA无明显“反跳”,两者用药有协同作用。可作为慢性乙型肝炎可供选择的治疗方法。

OBJECTIVE To study the therapeutic efficacy of the combination of LMD and FCV in patients with chronic hepatitis B. METHODS Combination therapy group were with LMD (100 mg qd) and FCV (500mg tid) o-rally for 12 months as a course of treatment, and LMD group alone were with LMD (100mg qd). Clinical evaluation and lab inspections ware done in the 1st, 3rd, 6th, 9th and 12th month after the treatment was started and in the 3rd, 6th and 12th month after the treatment was completed. RESULTS ALT of the therapeutic alliance group was higher than that of the Lamivudine group after 6 months' or 12 months' treatment or follow-up with significame difference. HBeAg/anti-Hbe seroconversion of the therapeutic group was higher than that of the Lamivudine group after 6 month or 12 month treatment or follow-up, but both groups didn't have much significance difference. CONCLUSIONS Combination of LMD and FCV has synergistic or additive anti-HBV effects, and may be an alternative therapy for patients with active chronic hepatitis B.